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Alliende LM, Strauss GP, Yang LH, Mittal VA. Perceptions of stigma in youth at clinical high risk for psychosis and depressive symptomatology. Schizophr Res 2024; 269:79-85. [PMID: 38754312 DOI: 10.1016/j.schres.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/16/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
It is unclear what types of stigma youth at clinical high risk for psychosis (CHR) experience, and the relationship between them and symptomatology. 94 CHR youth, and a control group of 45 youth with no psychosis spectrum symptoms (NP) were rated for perceived devaluation (i.e. negative views from others) and internalized mental health stigma (i.e. the extent to which they would agree with said views) as well as positive and mood symptomatology. CHR youth reported stigma more frequently than the NP group (χ2(1) = 53.55, p < .001) and at higher levels (perceived devaluation: t (137) = 8.54, p < .001; internalized stigma: t (137) = 7.48, p < .001). Surprisingly, in the CHR group, positive symptoms held no significant relationship to stigma measures. However, ratings of perceived devaluation stigma were associated with depressive symptomatology (β = 0.27, t = 2.68, p = .0087) and depression scores were conversely associated with perceived devaluation stigma (β = 0.30, t = 2.05, p = .043). These findings speak to the relationship between depressive symptomatology and perceived devaluation stigma in CHR youth. Perceived devaluation stigma showed greater clinical significance and could have different mechanisms than internalized stigma in CHR youth. It is also noteworthy that while positive symptoms play a central role in defining the CHR syndrome, they seem less relevant to the experience of stigma than mood symptoms. These findings highlight the importance of interventions aimed at ameliorating youth's exposure to negative views about mental health as those managing depressive symptomatology.
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Affiliation(s)
| | | | - Lawrence H Yang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, USA
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Batterham PJ, Gulliver A, Heffernan C, Calear AL, Werner-Seidler A, Turner A, Farrer LM, Chatterton ML, Mihalopoulos C, Berk M. A Brief Workplace Training Program to Support Help-Seeking for Mental Ill-Health: Protocol for the Helipad Cluster Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e55529. [PMID: 38787608 PMCID: PMC11161717 DOI: 10.2196/55529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/25/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Most people with mental health problems do not seek help, with delays of even decades in seeking professional help. Lack of engagement with professional mental health services can lead to poor outcomes and functional impairment. However, few effective interventions have been identified to improve help-seeking in adults, and those that exist are not widely implemented to deliver public health impact. Co-designing interventions with people with lived experience of mental ill-health and other relevant stakeholders is critical to increase the likelihood of uptake and engagement with these programs. OBJECTIVE This study aims to (1) test the effectiveness of a co-designed help-seeking program on increasing professional help-seeking intentions in employees in a workplace setting; (2) determine whether the program reduces mental illness stigma and improves help-seeking intentions and behavior, mental health literacy, mental health symptoms, and work and activity functioning relative to the control condition; (3) explore factors that facilitate broader implementation of the co-designed program; and (4) explore the cost-effectiveness of the co-designed program compared to the control condition over 6 months. METHODS A 2-arm cluster randomized controlled trial will be conducted (target sample: N=900 from 30 to 36 workplaces, with n=25 to 35 participants per workplace). The trial will compare the relative effectiveness of an enhanced interactive program (intervention condition) with a standard psychoeducation-alone program (active control condition) on the primary outcome of professional help-seeking intentions as measured by the General Help-Seeking Questionnaire. Secondary outcomes include the impact on mental illness stigma; mental health literacy; help-seeking attitudes and behavior; work and activity functioning; quality of life; and symptoms of mental ill-health including depression, anxiety, and general psychological distress. RESULTS Facilitators of and risks to the trial are identified and addressed in this protocol. Recruitment of workplaces is scheduled to commence in the first quarter of 2024. CONCLUSIONS If effective, the program has the potential to be ready for rapid dissemination throughout Australia, with the potential to increase appropriate and efficient service use across the spectrum of evidence-based services. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000270617p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385376. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55529.
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Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Cassandra Heffernan
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Alison L Calear
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | | | - Alyna Turner
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Louise M Farrer
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Acton, Australia
| | - Mary Lou Chatterton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
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García-Soriano G, Arnáez S, Chaves A, Del Valle G, Roncero M, Moritz S. Can an app increase health literacy and reduce the stigma associated with obsessive-compulsive disorder? A crossover randomized controlled trial. J Affect Disord 2024; 350:636-647. [PMID: 38253133 DOI: 10.1016/j.jad.2024.01.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a disabling condition with a high delay in seeking treatment. esTOCma is an app developed to increase mental health literacy (MHL) about OCD, reduce stigma, and increase the intention to seek professional treatment. It is a serious game and participants are asked to fight against the "OCD stigma monster" by accomplishing 10 missions. The aim of this study is to evaluate the effectiveness of this app in a community sample. METHODS A randomized controlled trial with a crossover design was carried out. Participants were randomized to two groups: immediate use (iApp, n = 102) and delayed use (dApp, n = 106) of esTOCma. The iApp group started using the app at baseline until the game was over. The dApp group initiated at 10-days until the game finished. Participants were requested to complete a set of questionnaires at baseline and 10-day, 20-day and 3-month follow-ups. RESULTS The Time×Group interaction effect was significant for the primary outcome measures: there was an increase in MHL and intention to seek help, and a decrease in stigma and OC symptoms, with large effect sizes, only after using the app. Changes were maintained (or increased) at follow-up. LIMITATIONS The study did not include an active control group and some of the scales showed low internal consistency or a ceiling effect. CONCLUSIONS This study provides first evidence for the effectiveness of esTOCma as a promising intervention to fight stigma and reduce the treatment gap in OCD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04777292. Registered February 23, 2021, https://clinicaltrials.gov/ct2/show/NCT04777292.
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Affiliation(s)
- Gemma García-Soriano
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain.
| | - Sandra Arnáez
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain.
| | - Antonio Chaves
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain.
| | - Gema Del Valle
- Agencia Valenciana de Salud, Unidad de Salud Mental, Departamento 04, Avda. Sants de la Pedra, 81, 46500 Sagunto, Spain.
| | - María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain.
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Hamburg-Eppendorf, Germany.
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Lawrence AL, Willis GM. Facilitators and Barriers to Understanding and Accepting People with a Sexual Interest in Children: A Thematic Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1361-1375. [PMID: 38110846 DOI: 10.1007/s10508-023-02757-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023]
Abstract
The widespread conflation between having a sexual interest in children and engaging in sexually abusive behavior contributes significantly to elevated levels of stigma targeted at people living with a sexual interest in children. Stigmatization and societal punitiveness surrounding people living with these interests can impact their well-being, obstruct help-seeking, and potentially increase risk of offending behavior. Recent quantitative research employing stigma intervention strategies has produced encouraging results in reducing stigmatizing attitudes toward this population. The current study sought to expand on quantitative research findings to explore qualitatively the facilitators and barriers to understanding and accepting people living with sexual interest in children. Thirty participants were interviewed following completion of an online stigma intervention study. Participants were asked about their attitudinal responses to the earlier study and how personal and professional experiences contributed to shaping their attitudes surrounding people living with a sexual interest in children. Reflexive inductive thematic analysis was used to explore what factors promote understanding and what factors act as barriers to understanding people with sexual interest in children. The significance of experiences which challenged the dominant social narrative was identified across several themes which facilitated understanding and acceptance of people who have a sexual interest in children. Themes which reflected barriers to understanding included difficulty comprehending alternate narratives, parental concern, and reinforcement of current stereotypes. Implications for developing stigma-reduction interventions and future research are discussed.
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Affiliation(s)
- Amy L Lawrence
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Gwenda M Willis
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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5
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Chaves A, Arnáez S, García-Soriano G. The Effectiveness of a Cell Phone eHealth App in Changing Knowledge, Stigmatizing Attitudes, and Intention to Seek Help Associated With Obsessive-Compulsive Disorder: Pilot Questionnaire Study. JMIR Mhealth Uhealth 2024; 12:e48027. [PMID: 38551629 PMCID: PMC11015362 DOI: 10.2196/48027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 12/17/2023] [Accepted: 02/01/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a disabling disorder associated with high interference in people's lives. However, patients with OCD either do not seek help or delay seeking help. Research suggests that this could be explained by poor mental health literacy about the disorder and the associated stigma. OBJECTIVE This study aims to evaluate the feasibility, acceptability, and preliminary effectiveness of a mental health mobile app, esTOCma, developed to improve knowledge about OCD and its treatment, increase help-seeking intention, and reduce stigmatizing attitudes and social distance associated with OCD. METHODS We used preintervention, postintervention, and 3-month follow-up assessments in this single-arm pilot intervention. Overall, 90 participants were recruited from the community using the snowball sampling method. We used esTOCma to defeat the "stigma monster" over the course of 10 missions. The participants completed the sociodemographic information and Obsessive-Compulsive Inventory-Revised at preassessment and an acceptability questionnaire at postassessment. All other measures were completed at the preassessment, postassessment, and 3-month follow-up (ie, the Spanish Mental Illness Stigma Attribution Questionnaire-27, the General Help-Seeking Questionnaire, the Social Distance Scale, and the Mental Health Literacy Questionnaire). RESULTS Of the 90 participants from the community that were assessed for eligibility, 86% (n=78) were allocated to intervention. Of these 78 participants, 79% (n=62) completed the game and answered the postintervention assessment (completer group). Overall, 69% (43/62) of the participants also completed the 3-month follow-up assessment. The participants completing the study were older (P=.003) and had a higher baseline knowledge of OCD (P=.05). The participants took an average of 13.64 (SD 10.50) days to complete the intervention, including the pre- and postassessments. The participants spent an average of 4.56 (SD 3.33) days completing the 10 missions included in the app. Each mission took a mean of between 2 (SD 3.01) and 9.35 (SD 3.06) minutes. The app was rated as useful or very useful by the vast majority of participants 90% (56/62). Moreover, 90% (56/62) of the participants reported that they had learned or learned a lot, and 98% (61/62) of the participants reported that they would recommend the app to a friend. Repeated measures ANOVA (43/62, 69%) showed that after the intervention participants showed an increased knowledge of mental health and intention to seek help as well as fewer stigmatizing attitudes and less social distance. CONCLUSIONS Preliminary data show that esTOCma is a feasible and acceptable app, and after completing its 10 missions, there is an increase in the understanding of OCD and help-seeking intention along with a decrease in the social stigma and social distance associated with OCD that lasts for at least 3 months. The results support the potential of technology-based interventions to increase the intention to seek help and reduce the stigma associated with OCD. A larger, community-controlled study is also recommended.
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Affiliation(s)
- Antonio Chaves
- Departamento de Orientación Educativa, IES Cid Campeador, Conselleria d'Educació, Cultura i Esport, Valencia, Spain
| | - Sandra Arnáez
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | - Gemma García-Soriano
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
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Du N, Wang Y, Huang YT. Parental Depression and Self-Stigma Among Chinese Young People Living With Depression: A Qualitative Study. QUALITATIVE HEALTH RESEARCH 2024:10497323241232351. [PMID: 38462846 DOI: 10.1177/10497323241232351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Self-stigma is detrimental to psychosocial well-being and the recovery journey among people living with depression. However, there has been limited research exploring the experience of stigma internalization when depression runs in families. This study aims to address this gap by (1) characterizing the manifestations of self-stigma among individuals living with depression whose parent(s) also have depression and (2) exploring the potential mechanisms underlying the impact of parental depression on self-stigma. Essential principles of the constructivist grounded theory approach were adopted to collect data through in-depth interviews with 27 participants aged 15-30, living in Mainland China. Many participants perceived depression running in their family as an endless disaster and an incurable illness. These beliefs further led to stigmatizing emotions (such as suppression, anger, and guilt) and behaviors (such as concealment and social withdrawal). Participants also highlighted ambivalent intergenerational relationships, tense family atmospheres, lower parental emotional involvement and support, and a lack of family flexibility due to parental depression. Furthermore, parental depression impacted participants' self-stigma by interfering with family relationships, family functioning, and parenting styles. It also shaped their perceptions of family, illness attribution, and public stigma. Additionally, parental depression had an impact on participants' social functioning, self-esteem, and personality, making them more susceptible to self-stigma. This study emphasizes the crucial role that the family plays in the internalization of stigma among individuals living with depression. It suggests that family dynamics, rather than family structure or economic backgrounds alone, shape this process.
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Affiliation(s)
- Nan Du
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Yihang Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Yu-Te Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
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7
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Cosh SM, McNeil DG, Jeffreys A, Clark L, Tully PJ. Athlete mental health help-seeking: A systematic review and meta-analysis of rates, barriers and facilitators. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 71:102586. [PMID: 38128709 DOI: 10.1016/j.psychsport.2023.102586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
Athletes are vulnerable to a range of mental health symptoms, in part due to stressors within the sport environment. An early intervention framework suggests the benefits of routine screening and referral for mental health, however, greater understanding around athlete help-seeking is needed to support referral uptake. This review examined rates of formal help-seeking behaviour as well as barriers and facilitators to help-seeking in sport settings. Relevant studies were retrieved from SportDiscus, PubMed and PsycInfo, with unpublished studies identified through contacting authors. Help-seeking rates were meta-analysed and barriers and facilitators were meta-synthesised. Twenty-two studies were included. Help-seeking rates were reported in 11 studies (N = 3415) and the pooled proportion of help-seeking was 22.4 % (95 % CI 16.2-30.2, I2 = 95.7 %). Barriers were reported in 13 studies and facilitators in six, highlighting a range of sporting-specific factors, such as stigma in relation to athlete identity and sport culture, fear of deselection, and concerns around confidentiality in sport settings, in addition to lack of awareness, low mental health literacy, and negative attitudes to services. Normalising experiences of mental health in sport settings, including through role models, was a key facilitator to help-seeking. Results provide implications for sport organisations to promote help-seeking and athlete mental health, such as through the use of role models, ensuring clarity around confidentiality, stigma reduction interventions, and fostering team cultures that promote mental health. Findings also support the value of sport staff in facilitating help-seeking, and organisational culture changes to foster wellbeing.
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Affiliation(s)
- S M Cosh
- School of Psychology, University of New England, Armidale, Australia; School of Psychology, The University of Adelaide, Adelaide, Australia.
| | - D G McNeil
- Institute of Health and Wellbeing, Federation University, Ballarat, Australia
| | - A Jeffreys
- School of Psychology, University of New England, Armidale, Australia
| | - L Clark
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - P J Tully
- School of Psychology, University of New England, Armidale, Australia; Discipline of Medicine, The University of Adelaide, Adelaide, Australia
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Wong JCM, Chua JYX, Chan PY, Shorey S. Effectiveness of educational interventions in reducing the stigma of healthcare professionals and healthcare students towards mental illness: A systematic review and meta-analysis. J Adv Nurs 2024. [PMID: 38402635 DOI: 10.1111/jan.16127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
AIM To examine the effectiveness of educational interventions in reducing stigma among healthcare professionals and students towards people with mental illness. DESIGN A systematic review and meta-analysis of randomized controlled trials (RCTs) and cluster RCTs. DATA SOURCES Articles published from database inception to October 2023 were systematically searched from seven databases (CINAHL, Embase, ProQuest Dissertations and Theses Global, PsycINFO, PubMed, Scopus, Web of Science), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Random-effect meta-analyses were conducted. Heterogeneity was evaluated using the I2 statistics and Cochran's Q chi-squared test. A quality appraisal conducted at the study level used the Cochrane risk of bias tool and an outcome-level quality assessment utilized the Grades of Recommendation, Assessment, Development and Evaluation Approach. Publication bias was assessed using the funnel plot. RESULTS Twenty-five articles were included in this review. Meta-analysis reported statistically significant medium and small effect sizes for attitudes towards mental illness and attitudes towards people with mental illness respectively, showing the association between educational interventions and improved attitudes among healthcare professionals and students. However, a statistically non-significant effect was reported for knowledge of mental illness. Subgroup analyses indicated that face-to-face and contact-based interventions were particularly effective at reducing stigma. Notably, single-session interventions were just as effective as multiple sessions, suggesting a potential for resource-efficient approaches. CONCLUSION Educational interventions demonstrate promise in fostering more positive attitudes towards mental health issues. Future research should aim to determine the long-term effects of these interventions and include patient feedback on the stigmatizing behaviours of healthcare professionals and students, to holistically evaluate the effect of interventions. NO PATIENT OR PUBLIC CONTRIBUTION This study is a secondary review and does not require relevant contributions from patients or the public. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Face-to-face contact-based educational sessions have proven to be the most effective. Reinforcing learning may be achieved through a series of repeated single-session interventions.
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Affiliation(s)
- John Chee Meng Wong
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Pao Yi Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Rodríguez-Rivas ME, Cangas AJ, Martin A, Romo J, Pérez JC, Valdebenito S, Cariola L, Onetto J, Hernández B, Ceric F, Cea P, Corrigan P. Reducing Stigma Toward People with Serious Mental Illness Through a Virtual Reality Intervention: A Randomized Controlled Trial. Games Health J 2024; 13:57-64. [PMID: 37695822 DOI: 10.1089/g4h.2023.0118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
Background: Stigma toward people with serious mental illnesses (SMI), like schizophrenia, is a serious global public health challenge that limits the quality of life of those affected and poses a major barrier that keeps people from seeking professional help. There is an urgent need for novel, effective, and scalable interventions to decrease stigmatized perceptions of chronic psychotic disorders and to reduce the health burden imposed by them. Method: We conducted a randomized controlled trial to assess the impact of a new immersive virtual reality game (Inclúyete-VR) on the level of stigma toward people with SMI, measured by the Attribution questionnaire (AQ-27). Participants in the experimental group were exposed in an immersive way to hallucinations common in schizophrenia, then shown different psychosocial resources available for their recovery and social inclusion; those in the control group used VR software unrelated to mental health. VR sessions were delivered through Oculus headgear and lasted 25 minutes. Results: We randomly assigned 124 university students (55% female) to experimental or control conditions (n = 62 each). We used mixed ANOVA to compare outcomes before and after the intervention between the two groups. We found a significant intervention-by-time interaction (P < 0.001), with a reduction in the experimental group of overall stigma levels on the AQ-27 scale and its three subscales: dangerousness-fear, avoidance, and lack of solidarity (P < 0.001 for all). Conclusions: The Inclúyete-VR software proved effective in the short term in reducing stigma toward people with severe mental illness. The program's longer-term efficacy, scalability, and dissemination remain to be studied. ClinicalTrials.gov Identifier: NCT05393596.
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Affiliation(s)
| | - Adolfo J Cangas
- Department of Psychology, Health Research Center, University of Almería, Almería, Spain
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Javiera Romo
- Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - J Carola Pérez
- Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Laura Cariola
- Department of Clinical and Health Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Josefina Onetto
- Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | | | - Francisco Ceric
- Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Pablo Cea
- Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
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Holst H, Ozolins LL, Enros J, Schmidt M, Hörberg U. Life situation of older people living with severe mental illness - A scoping review. Int J Ment Health Nurs 2024. [PMID: 38174768 DOI: 10.1111/inm.13288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
An increasing number of older people with severe mental illness (SMI) poses additional challenges to healthcare and social services. This scoping review aimed to investigate the life situation of older people living with severe mental illness and identify the research gaps in the existing literature. The current review followed the methodological framework for conducting scoping reviews by Arksey and O'Malley, consisting of five main stages: (1) identifying the research question (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarising, and reporting the results. An optional sixth stage, a consultation exercise, has also been used in this study: The scoping review was conducted in accordance with the PRISMA extension for scoping reviews PRISMA-ScR, and the databases PsychINFO Scopus, Cinahl, Web of Science and PubMed were used. A total of 24 studies were included in the review. The thematic analysis focused on: (1) the perspective of older people with SMI, (2) the perspective of healthcare professionals supporting older people with SMI, and (3) the perspective of informal carers supporting older people with SMI. The results describe the life situation of older people living with SMI, especially in relation to the older peoples' experiences of suffering and well-being. The staff and the informal carers need adequate knowledge to provide support to the older people with SMI. To gain greater knowledge about the life situation and support needed by older people with SMI, we strongly advocate additional research focusing on their own experiences.
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Affiliation(s)
- Hanna Holst
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Lise-Lotte Ozolins
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Jessica Enros
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Manuela Schmidt
- Department of Quality Improvement and Leadership, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ulrica Hörberg
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Martínez-Martínez C, Sánchez-Martínez V, Aguilar-Gascón L, María Ortega-Galán Á, Diego Ramos-Pichardo J. Involving Persons With Lived Experience to Improve Vocational Students' Stigmatizing Attitudes Toward Mental Disorders: A Quasi-Experimental Study. J Am Psychiatr Nurses Assoc 2024; 30:160-168. [PMID: 35473399 DOI: 10.1177/10783903221090528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mental health problems are estimated to affect one in six individuals in the European Union. Fifty percent of mental disorders start in adolescence, around the age of 14. The stigma associated with having a mental health problem is one of the main barriers to seeking help for psychiatric and psychological disorders among adolescents and young adults. Interventions to reduce social stigma could contribute to increased help-seeking behavior in this population. AIMS: To assess the effectiveness of a direct contact intervention in the classroom by persons with lived experience to reduce vocational students' stigmatizing attitudes. METHOD: One person with lived experience and one first-degree relative implemented a classroom intervention lasting 90 min. Its effectiveness was measured using a quasi-experimental study with a pretest-posttest design and within-subject control. RESULTS: A total of 128 students from three different Vocational and Technical Schools from Spain participated in the study. After the intervention, statistically significant differences were observed in the scores of 11 of the 13 dimensions measured with the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E) and the Community Attitudes toward Mental Illness (CAMI) questionnaires. No differences associated with gender or familiarity with the mental disorder were observed. CONCLUSION: Vocational students' negative attitudes and emotions can be improved through a direct contact intervention in the classroom involving people who have experienced a mental disorder themselves. The age range for optimal results with this type of intervention appears to be 18 to 20 years.
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Affiliation(s)
- Concepción Martínez-Martínez
- Concepción Martínez-Martínez, PhD, MHN, RN, Assistant Professor, Faculty of Health Sciences, Department of Nursing and Physiotherapy, Universidad Europea, Valencia, Spain
| | - Vanessa Sánchez-Martínez
- Vanessa Sánchez-Martínez, PhD, MHN, RN, Associate Professor, Faculty of Nursing and Chiropody, Department of Nursing, University of Valencia, Spain
| | - Laura Aguilar-Gascón
- Laura Aguilar-Gascón, PsyD, MSC, Volunteer in ASIEM (Spanish Acronym of the Association for the Integral Health of People with Mental Disorders), Valencia, Spain
| | - Ángela María Ortega-Galán
- Ángela María Ortega-Galán, PhD, MSN, RN, Assistant Professor, Department of Nursing, University of Huelva, Spain
| | - Juan Diego Ramos-Pichardo
- Juan Diego Ramos-Pichardo, PhD, MSN, RN, Associate Professor, Department of Nursing, University of Huelva, Spain
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Shi J, Chen Y, Jiang Y, Li Y, Wang W, Zhao H, Guo L, Liao Y, Zhang H, Gao C, McIntyre RS, Zhang WH, Han X, Lu C. Stigma and its associations with medication adherence in major depressive disorder. Psychiatry Res 2024; 331:115664. [PMID: 38070363 DOI: 10.1016/j.psychres.2023.115664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/02/2024]
Abstract
This study sought to evaluate internalized stigma (IS) and perceived stigma (PS), in persons (n = 522) living with major depressive disorder (MDD), with a view to analyzing the association of IS and PS with medication adherence in a cohort of participants with MDD in China. Perceived stigma is the awareness of societal negative views and attitudes towards depression, and IS is applying others' attitudes to oneself, both measured by the Depression Stigma Scale (DSS). Medication adherence was assessed using the Medication Adherence Rating Scale (MARS). We observed that 76.0 % of participants reported IS and 84.5 % reported PS. Factors associated with increased IS included older age, marital status, disease history, and a higher baseline Patient Health Questionnaire-9 (PHQ-9). Higher education level, family income, and scores on the Connor-Davidson Resilience Scale (CD-RISC) were associated with lower levels of IS. Higher education levels, Childhood Trauma Questionnaire (CTQ) scores, and living with others were also associated with higher PS, while engagement in exercise and higher number of prior episodes were associated with lower PS. IS had a negative association with medication adherence, whereas PS did not significantly associate with adherence. In conclusion, a testable hypothesis is derived from our data that strategies targeting IS amongst persons with MDD may improve overall rates of adherence to antidepressant treatment, a necessary prelude to improving recovery.
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Affiliation(s)
- Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yan Chen
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Yingchen Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Hao Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China
| | - Yuhua Liao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Huimin Zhang
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Caihong Gao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; School of Public Health, Université libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, No.7, Huaming Road, Shenzhen 518054, PR China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, PR China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, PR China.
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Szeto ACH, Henderson L, Lindsay BL, Knaak S, Dobson KS. Increasing resiliency and reducing mental illness stigma in post-secondary students: A meta-analytic evaluation of the inquiring mind program. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2909-2919. [PMID: 34875206 DOI: 10.1080/07448481.2021.2007112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 09/10/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
Objective: Worsening student mental health, along with more complex mental illness presentation and increased access to campus mental health services, has led to a mental health "crisis" on campuses. One way to address student mental health needs may be through mental health programs which have been found to increase resiliency and help-seeking, and reduce stigma. Participants: The effectiveness of The Inquiring Mind (TIM), a mental health promotion and mental illness stigma reduction program, was examined in 810 students from 16 Canadian post-secondary institutions. Methods and Results: Using a meta-analytic approach, TIM improved resiliency and decreased stigmatizing attitudes from pre to post, with medium effect sizes (d > .50). Analyses with those that completed the follow-up (about one-third of the sample) showed that effects were mostly retained at three months. Other outcomes also point to the program's effectiveness. Conclusion: TIM appears to be an effective program for post-secondary students. However, additional research, including randomized control trials, is needed to address study limitations.
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Affiliation(s)
- Andrew C H Szeto
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Mental Health Commission of Canada, Ottawa, Ontario, Canada
| | - Laura Henderson
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Brittany L Lindsay
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Stephanie Knaak
- Mental Health Commission of Canada, Ottawa, Ontario, Canada
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Keith S Dobson
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Mental Health Commission of Canada, Ottawa, Ontario, Canada
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Valdivia Ramos HN, Mora-Rios J, Natera G, Mondragón L. Psychometric properties of the Mexican version of the opening minds stigma scale for health care providers (OMS-HC). PeerJ 2023; 11:e16375. [PMID: 38025693 PMCID: PMC10655721 DOI: 10.7717/peerj.16375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Healthcare providers are one of the main groups that contribute to the stigmatization of people with mental disorders. Apathy, accusation, fatalism, and morbid curiosity are the most common forms of stigmatization encountered, and these are associated with inadequate treatment, reduced treatment adherence, decreased help-seeking behavior, an increased risk of relapse, and complications with other medical conditions. The aim of this study was to examine the psychometric properties of an adapted Spanish version of the Opening Minds Stigma Scale (OMS-HC) for healthcare providers in Mexico and identify certain stigmatizing attitudes within this group. Methods An ex-post facto cross-sectional observational study was conducted with 556 healthcare providers in Mexico, with an average age of 29.7 years, who were mostly women (80.4%). Validity was examined through confirmatory factor analysis. Differences according to gender, discipline, occupation, and educational level were analyzed using multivariate methods. Results The factor structure of the OMS-HC, consisting of three subscales identified by the original authors of the instrument (attitudes of healthcare providers towards people with mental illness, secrecy/help-seeking, and social distance), was confirmed. The model demonstrated good fit (x2/df = 2.36, RMSEA = 0.050, CFI = 0.970, TLI = 0.962, SRMR = 0.054, NFI = 0.950, PNFI = 0.742). Internal consistency was found to be adequate (α = 0.73, ω = 0.76) for the scale itself and slightly lower than acceptable for the subscales. Significant differences were found by discipline, educational level, and, for student providers, by academic semester. Higher scores were observed on the OMS-HC scale among nursing and medical professionals, undergraduate students, and those in early semesters. Conclusions The Spanish version of the OMS-HC has demonstrated adequate psychometric properties and could be a useful tool to facilitate research on this topic in Mexico, and to carry out comparative studies with healthcare personnel in other Spanish-speaking countries.
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Affiliation(s)
- Hugo Noel Valdivia Ramos
- Programa de Maestría y Doctorado de Ciencias Médicas, Ontológicas y de la Salud, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Jazmín Mora-Rios
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Guillermina Natera
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Liliana Mondragón
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
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Krendl AC, Perry BL. Stigma Toward Substance Dependence: Causes, Consequences, and Potential Interventions. Psychol Sci Public Interest 2023; 24:90-126. [PMID: 37883667 DOI: 10.1177/15291006231198193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Substance dependence is a prevalent and urgent public health problem. In 2021, 60 million Americans reported abusing alcohol within the month prior to being surveyed, and nearly 20 million Americans reported using illegal drugs (e.g., heroin) or prescription drugs (e.g., opioids) for nonmedical reasons in the year before. Drug-involved overdose rates have been steadily increasing over the past 20 years. This increase has been primarily driven by opioid and stimulant use. Despite its prevalence, drug dependence is one of the most stigmatized health conditions. Stigma has myriad negative consequences for its targets, including limiting their access to employment and housing, disrupting interpersonal relationships, harming physical and mental health, and reducing help-seeking. However, because research on stigma toward people with substance use disorders (SUDs) is relatively sparse compared with research on stigma toward other mental illnesses, the field lacks a comprehensive understanding of the causes and consequences of SUD stigma. Moreover, it remains unclear how, if at all, these factors differ from other types of mental illness stigma. The goal of this review is to take stock of the literature on SUD stigma, providing a clear set of foundational principles and a blueprint for future research and translational activity.
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Affiliation(s)
- Anne C Krendl
- Department of Psychological and Brain Sciences, Indiana University Bloomington
| | - Brea L Perry
- Department of Sociology, Indiana University Bloomington
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16
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Kirchhoff S, Fretian AM, Okan O, Bauer U. Evaluating the effect of an adapted mental health literacy intervention on mental health related stigma among secondary students in Germany: results of a pre-post evaluation study. BMC Public Health 2023; 23:1959. [PMID: 37817102 PMCID: PMC10563208 DOI: 10.1186/s12889-023-16825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/23/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Most mental health problems develop during youth, with about three quarter emerging before age 25. In adolescence, stigmatizing attitudes related to mental illness become more nuanced and consolidate into one's belief system. As the stigma of mental illness is still one of the leading barriers to help-seeking, intervention measures should explicitly address it before it becomes entrenched over time. Preventive measures, for example, based on promoting mental health literacy (MHL), can be used to address and tackle stigmatizing attitudes. The Canadian MHL-based intervention "the Guide" was translated and adapted for the use in German schools. The present study evaluates the effect of the German version of the Guide on attitudes towards mental illness among students in Germany. METHODS The first-time application of the Guide (German version) was evaluated with a pre-post-evaluation study with an intervention and a control group. The evaluation data of 188 students (intervention group n = 106, control group n = 82) were statistically analyzed focusing on the outcomes social stigma, social distance, and self-stigma. RESULTS The analysis showed that participants do not tend to hold stigmatizing attitudes even before the intervention. Nevertheless, the intervention was effective in reducing social stigma, but not in reducing social distance and self-stigma. Neither gender, pre-existing experience with mental illness, nor the delivery modality of the contact element within the intervention (speaker vs. video) seemed to influence the outcomes. CONCLUSIONS The German version of the MHL-based intervention, the Guide, seems to be a suitable intervention to improve attitudes towards mental illness among students in Germany. More extensive research is necessary to confirm the findings and further explore factors that influence the program's effects on attitudes short- and long-term.
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Affiliation(s)
- Sandra Kirchhoff
- Department of Sport and Health Sciences, Technical University of Munich, 80992, Munich, Germany
- Faculty of Educational Science, Bielefeld University, 33615, Bielefeld, Germany
| | - Alexandra M Fretian
- Faculty of Educational Science, Bielefeld University, 33615, Bielefeld, Germany
| | - Orkan Okan
- Department of Sport and Health Sciences, Technical University of Munich, 80992, Munich, Germany
| | - Ullrich Bauer
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615, Bielefeld, Germany.
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Faruk MO, Khan AH, Chowdhury KUA, Jahan S, Sarker DC, Colucci E, Hasan MT. Mental illness stigma in Bangladesh: Findings from a cross-sectional survey. Glob Ment Health (Camb) 2023; 10:e59. [PMID: 37854431 PMCID: PMC10579681 DOI: 10.1017/gmh.2023.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/12/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
Background Mental illness stigma is universally prevalent and a significant barrier to achieving global mental health goals. Mental illness stigma in Bangladesh has gained little attention despite its widespread impact on seeking mental health care in rural and urban areas. This study aimed to investigate mental illness stigma and the associated factors in rural and urban areas of Bangladesh. Methods The study areas were divided into several clusters from which 325 participants (≥18 years) were recruited with systematic random sampling. The Bangla version of the Days' Mental Illness Stigma Scale was used to collect data. Independent-samples t-test, ANOVA, and multiple regression were performed. Results Results suggest that gender, age, geographical location, socioeconomic status, and occupation significantly differed across subscales of stigma. Age, gender, seeking treatment of mental illness, having knowledge on mental health, and socioeconomic status were predictive factors of mental illness stigma. The results also showed a high treatment gap in both rural and urban areas. Conclusion This study supports that mental illness stigma is prevalent in Bangladesh, requiring coordinated efforts. Results can inform the development of contextually tailored mental health strategies to reduce stigma and contribute to the promotion of mental health of individuals and communities across Bangladesh.
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Affiliation(s)
- Md Omar Faruk
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Abid Hasan Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Kamal Uddin Ahmed Chowdhury
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
- Nasirullah Psychotherapy Unit, Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Sabiha Jahan
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Depon Chandra Sarker
- Child Development Center, Department of Pediatrics, Satkhira Medical College and Hospital, Satkhira, Bangladesh
| | | | - M. Tasdik Hasan
- Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, VIC, Australia
- Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh
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Matsumoto H, Hagiwara Y, Yamamoto-Mitani N, Igarashi A. A Randomized Control Trial for ReDeSign: A Dementia-Friendly Mobile Microlearning Training for Store Workers in Japan. THE GERONTOLOGIST 2023; 63:1300-1310. [PMID: 36508394 PMCID: PMC10474589 DOI: 10.1093/geront/gnac182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Dementia-friendly training should be incorporated in neighborhood stores for people living with dementia to maintain engagement in social activities. However, there is a lack of evidence of dementia-friendly training in these workplaces, and existing trainings have time constraints. We developed a mobile microlearning program based on stigma theory and the bystander intervention model. This study aimed to evaluate the microlearning program's effectiveness. RESEARCH DESIGN AND METHODS Convenience store workers in Tokyo were recruited for a randomized, waiting-list, and controlled trial. The intervention group completed a 50-min online course. The primary outcome was an attitude toward people living with dementia. The secondary outcomes were knowledge of dementia and helping behavior toward customers suspected of having dementia. Data were collected at baseline, after 1 month, and 4 months following the randomization. RESULTS Process evaluations confirmed satisfaction and high completion rates of the program. In total, 150 participants were included in the analysis. The intervention group showed significantly greater improvements in attitude (Hedge's g = 0.70) and knowledge (g = 0.59) after 1 month, compared to the control group. Helping behavior increased in the intervention group, although it did not differ significantly between the groups. All outcomes remained significantly improved after 4 months. DISCUSSION AND IMPLICATIONS The findings provide evidence that dementia-friendly training reduces the general public's stigma and increases helping behavior in stores. Mitigation of time constraints through mobile microlearning is expected to contribute to the dissemination and help people living with dementia maintain their social participation in the communities. Clinical Trials Registration Number: UMIN000043623.
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Affiliation(s)
- Hiroshige Matsumoto
- Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuhiro Hagiwara
- Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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DuPont-Reyes MJ, Villatoro AP, Datzman J, Phelan JC, Painter K, Barkin K, Link BG. Inequities Gone or Enduring? Evaluating the Effects of a School-Based Antistigma Intervention on Race/Ethnic and Gender Intersectional Disparities in Mental Illness Stigma. STIGMA AND HEALTH 2023; 8:381-392. [PMID: 37636031 PMCID: PMC10454522 DOI: 10.1037/sah0000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
While significant mental illness stigma disparities across race/ethnicity and gender exist, little is known about the efficacy of anti-stigma interventions in reducing these intersectional disparities. We examine the two-year effects of school-based anti-stigma interventions on race/ethnic and gender intersectional stigma disparities among adolescents. An ethnically and socioeconomically diverse sixth grade sample (N = 302) self-completed surveys assessing stigma before randomly receiving an anti-stigma curriculum and/or contact intervention versus no intervention. Surveys were also self-completed two-years post-intervention. Stigma measures assessed general mental illness knowledge/attitudes, awareness/action, and social distance. Stigma towards peers with specific mental illnesses were examined using vignettes-two adolescent characters were described as having bipolar (Julia) and social anxiety (David) disorder. Race/ethnicity and gender were cross-classified into six intersectional groups (Latina/o, Non-Latina/o Black, and Non-Latina/o White girls and boys). Linear regressions adjusting for poverty and mental illness familiarity examined anti-stigma intervention effects across intersectional groups in sixth and eighth grade. The school-based anti-stigma intervention reduced intersectional stigma disparities over the two-year study period. While Non-Latino Black boys and Latino boys/girls reported greater disparities in stigma at baseline compared to Non-Latina White girls, these disparities (14 total) were predominantly eliminated in the two-year follow-up following receipt of the curriculum and contact components to just one remaining disparity post-intervention among Non-Latino Black boys. By identifying differences in how school-based anti-stigma interventions reduce mental illness stigma for unique race/ethnic and gender intersectional groups, we can better understand how to shape future anti-stigma interventions for diverse intersectional populations.
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Affiliation(s)
- Melissa J. DuPont-Reyes
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
- Department of Epidemiology, Columbia University Mailman School of Public Health
| | | | - Jared Datzman
- Department of Epidemiology and Biostatistics, Texas A&M University
| | - Jo C. Phelan
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
| | - Kris Painter
- School of Social Work, The University of Texas in Arlington
| | | | - Bruce G. Link
- School of Public Policy, University of California, Riverside
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Sheppard H, Bizumic B, Calear A. Prejudice toward people with borderline personality disorder: Application of the prejudice toward people with mental illness framework. Int J Soc Psychiatry 2023; 69:1213-1222. [PMID: 36794515 PMCID: PMC10338706 DOI: 10.1177/00207640231155056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND People living with borderline personality disorder (BPD) face high levels of prejudice and discrimination from both the community and medical professionals, but no measure of prejudice toward people living with BPD exists. AIMS The current study aimed to adapt an existing Prejudice toward People with Mental Illness (PPMI) scale and investigate the structure and nomological network of prejudice toward people with BPD. METHODS The original 28-item PPMI scale was adapted to create the Prejudice toward People with Borderline Personality Disorder (PPBPD) scale. The scale and related measures were completed by three samples: 217 medical or clinical psychology students, 303 psychology undergraduate students, and 314 adults from the general population. RESULTS The original four-factor structure of the PPMI was supported in the PPBPD scale. Reported prejudice toward people with BPD was more negative than prejudice toward people with mental illness in general. The association of the PPBPD scale with antecedents and consequences was assessed, including social dominance orientation, right-wing authoritarianism, ethnocentrism, personality traits, empathy, prior contact, and feelings toward other stigmatized groups and mental illnesses. CONCLUSIONS This study provided evidence for the validity and psychometric properties of the PPBPD scale across three samples and investigated anticipated relationships with theoretically related antecedents and consequences. This research will help improve understanding of the expressions underlying prejudice toward people with BPD.
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Affiliation(s)
- Hannah Sheppard
- Research School of Psychology, the Australian National University, Canberra, ACT, Australia
| | - Boris Bizumic
- Research School of Psychology, the Australian National University, Canberra, ACT, Australia
| | - Alison Calear
- Research School of Psychology, the Australian National University, Canberra, ACT, Australia
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Li L, Lu S, Xie C, Li Y. Stigmatizing attitudes toward mental disorders among non-mental health nurses in general hospitals of China: a national survey. Front Psychiatry 2023; 14:1180034. [PMID: 37599894 PMCID: PMC10433212 DOI: 10.3389/fpsyt.2023.1180034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Background Negative attitudes of nurses toward mental disorders have been reported in various countries. Nurses' stigmatizing attitudes can harm patients with mental disorders (PWMD), thereby delaying the provision of help to patients and leading to decreased quality of care. In this study, we aimed to assess Chinese nurses' stigmatizing attitudes toward patients with mental illness and provide a basis for future development and testing of appropriate and culturally adapted interventions to reduce it. Objective This study aimed to assess the attitudes of Non-mental Health Nurses (NMHNs) in general hospitals in China toward the stigma of PWMD and determine the factors influencing them. Methods A cross-sectional survey of NMHNs in general hospitals were conducted. A self-designed WeChat-based questionnaire was used that included demographic information about the need for training on mental health issues. Participants were provided with a vignette of a depression case with suicidal thoughts. The Depression Stigma Scale (DSS) and Social Distance Scale (SDS) were used to assess attitudes toward mental disorders. Nine questions on the adequacy of knowledge about anxiety and depression and the current status of scale use were used to assess the current status of training needs for mental disorders. Descriptive analysis, chi-square test, and multivariate logistic regression were used for the table. Results A total of 8,254 nurses in non-mental health professions participated in this study. The mean DSS score of NMHNs was (17.24 ± 6.700), and the SDS score was (10.34 ± 3.154). The total detection rate of stigma among the survey respondents was 13.40% (1,107/8254). Multivariate logistic regression showed that age between 30 and 39 years [p = 0.001, OR = 1.427 (1.154-1.764)], 4 years of work experience and above [p = 0.018, OR = 1.377 (1.056-1.796)], having a bachelor's degree [p < 0.001, OR = 0.742 (0.647-0.851)], adequate psychological knowledge [p < 0.001, OR = 1.567 (1.364-1.799)], full knowledge of communication with patients with anxiety and depression [p < 0.001, OR = 1.848 (1.389-2.459)], and the need to acquire skills to identify anxiety and depression were the influencing factors associated with stigma [p < 0.001, OR = 0.343 (0.236-0.499)]. Conclusion Stigmatizing attitudes toward PWMD exist among NMHNs in general hospitals in China. Thus, more mental health education programs for NMHNs are needed. Factors associated with higher morbidity stigma can be used to develop appropriate interventions to improve NMHNs' stigmatizing attitudes and provide better quality care to PWMD.
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Affiliation(s)
- Li Li
- Xiangya School of Nursing, Central South University, Changsha, China
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
- Department of Urology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Shurong Lu
- Centre for Mental Health | Melbourne School of Population and Global Health The University of Melbourne, Melbourne, VIC, Australia
| | - Chunyan Xie
- Xiangya School of Nursing, Central South University, Changsha, China
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
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Rackoff GN, Fitzsimmons-Craft EE, Taylor CB, Eisenberg D, Wilfley DE, Newman MG. Psychotherapy utilization by United States college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37436950 PMCID: PMC10784405 DOI: 10.1080/07448481.2023.2225630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 07/14/2023]
Abstract
Objective: We studied current psychotherapy utilization rates among college students with mental health problems and identified characteristics associated with differential utilization. Participants: Nationwide online survey of students screening positive for at least one clinical mental health problem (N = 18,435). Methods: Rates and correlates of psychotherapy utilization were analyzed descriptively and with logistic regression. Results: Sample-wide, 19% reported receiving psychotherapy. Being male (vs. female), being Asian, Black or African American, or Multiracial (vs. White), greater financial difficulty, lower parent education, lower year in school, and attending a public (vs. private) institution were associated with lower utilization. Holding a gender minority (vs. female) identity and holding a sexual minority (vs. heterosexual) identity were associated with higher utilization. Utilization fell from Fall 2019 to Spring 2020, early during the COVID-19 pandemic, and subsequently rebounded. Conclusions: This study estimates current psychotherapy utilization among students with mental health problems and identifies possibly underserved populations.
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Affiliation(s)
- Gavin N. Rackoff
- Department of Psychology, The Pennsylvania State University, University Park, PA
| | | | - C. Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
- Center for mHealth, Palo Alto University, Palo Alto, CA
| | - Daniel Eisenberg
- Department of Health Policy and Management, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Michelle G. Newman
- Department of Psychology, The Pennsylvania State University, University Park, PA
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Kulwicka K, Gasiorowska A. Depression literacy and misconceptions scale (DepSter): a new two-factorial tool for measuring beliefs about depression. BMC Psychiatry 2023; 23:300. [PMID: 37127570 PMCID: PMC10150464 DOI: 10.1186/s12888-023-04796-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 04/18/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Depression literacy has received extensive attention within mental health research. It has been studied by different social groups and professions in Western and non-Western cultures. The importance of this topic stems from the fact that depression literacy is strongly related to attitudes toward people who are diagnosed with depression, the tendency to stigmatize this mental disorder, and to the propensity to undertake help-seeking behaviors. Therefore, understanding and promoting depression literacy is crucial in contemporary mental health prevention and promotion. We propose a new two-factorial tool measuring beliefs about depression. This 14-item self-report measure captures how people vary across two dimensions of beliefs about depression-depression literacy and misconceptions about depression. METHODS In ten studies with a total sample of over 4,600 participants from three countries, we demonstrated the two-factorial structure of the Depression Literacy and Misconceptions Scale (DepSter) in Polish (Studies 1 and 2), American (Study 4), and British (Study 5) samples. We showed measurement equivalence for the Polish and English versions of the scale (Study 3). Furthermore, we tested the discriminant meaning of the two dimensions of beliefs about depression analyzing its association with health literacy, mental health literacy, and prejudice toward people with mental illness (Study 4), depression literacy and depression stigma (Study 5), empathetic concerns (Study 7), social dominance orientation (Study 8), and the Big Five personality traits (Study 9). We also investigated whether individuals with formal education in psychology and direct or indirect experience with depression demonstrate a higher level of depression literacy and a lower level of misconceptions about depression (Study 6). Our measure showed high stability for two dimensions of beliefs about depression (Study 10), in both its Polish and English versions, with the measurement conducted after three weeks and three months. DISCUSSION We conclude that the proposed approach to beliefs about depression capturing both depression literacy and misconceptions about depression measured with the DepSter scale can easily be applied in clinical and social settings, especially in studies concerning the perception of those diagnosed with depression.
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Affiliation(s)
- Katarzyna Kulwicka
- Faculty of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Warszawa, Poland.
| | - Agata Gasiorowska
- Faculty of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Warszawa, Poland
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Phipps JE, Whipps MDM, D'Souza I, LaSalle JM, Simmons LA. Pregnant in a Pandemic: Mental Wellbeing and Associated Healthy Behaviors Among Pregnant People in California During COVID-19. Matern Child Health J 2023:10.1007/s10995-023-03657-w. [PMID: 37029891 PMCID: PMC10083068 DOI: 10.1007/s10995-023-03657-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION Pregnancy is a time of increased vulnerability to mental health disorders. Additionally, the COVID-19 pandemic has increased the incidence of depression and anxiety. Thus, we aimed to assess mental health and associated healthy behaviors of pregnant people in California during the pandemic in order to contextualize prenatal well-being during the first pandemic of the twenty-first century. METHODS We conducted an online cross-sectional study of 433 pregnant people from June 6 through July 29, 2020. We explored 3 hypotheses: (1) mental health would be worse during the pandemic than in general pregnant samples to date; (2) first-time pregnant people would have worse mental health; and (3) healthy behaviors would be positively related to mental health. RESULTS Many of our participants (22%) reported clinically significant depressive symptoms and 31% reported clinically significant anxiety symptoms. Multiparous pregnant people were more likely to express worries about their own health and wellbeing and the process of childbirth than were primiparous pregnant people. Additionally, as pregnancy advanced, sleep and nutrition worsened, while physical activity increased. Lastly, anxious-depressive symptomology was significantly predictive of participant sleep behaviors, nutrition, and physical activity during the past week. DISCUSSION Pregnant people had worse mental health during the pandemic, and this was associated with worse health-promoting behaviors. Given that the COVID-19 pandemic and associated risks are likely to persist due to low vaccination rates and the emergence of variants with high infection rates, care that promotes mental and physical well-being for the pregnant population should be a public health priority.
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Affiliation(s)
- Jennifer E Phipps
- Department of Human Ecology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA.
| | - Mackenzie D M Whipps
- Department of Human Ecology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
| | - Indira D'Souza
- Department of Human Ecology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
| | - Janine M LaSalle
- Department of Medical Microbiology and Immunology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
| | - Leigh Ann Simmons
- Department of Human Ecology, Perinatal Origins of Disparities Center, University of California, Davis, 1 Shields Ave, Davis, CA, 95616, USA
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Amsalem D, Jankowski SE, Pagdon S, Valeri L, Yang LH, Markowitz JC, Neria Y, Pescosolido BA, Dixon LB, Martin A. Selfie Videos to Reduce Stigma and Increase Treatment Seeking Among Youths: Two Noninferiority Randomized Controlled Trials. Psychiatr Serv 2023; 74:229-236. [PMID: 36254455 DOI: 10.1176/appi.ps.20220168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Confronting stigma early in life could enhance treatment seeking. In two randomized controlled trials (RCTs), one focused on psychosis and the other on adolescent depression, the efficacy and equivalence of brief social contact-based videos were evaluated and compared with a control condition. The outcomes of interest were changes in illness-related stigma and treatment-seeking intention. The hypotheses were that the intervention videos would show greater efficacy than control conditions and that traditional and selfie videos would demonstrate similar efficacy. METHODS Young adults (study 1, N=895) and adolescents (study 2, N=637) were randomly assigned to view intervention videos (in traditional or selfie styles) or to a control condition. In short videos (58-102 seconds), young presenters humanized their illness by emotionally describing their struggles and discussing themes of recovery and hope. RESULTS Repeated-measures analyses of variance and paired t tests showed significant differences in stigma and treatment seeking between the intervention and control groups and similar efficacy of the traditional and selfie videos. Cohen's d effect sizes ranged from 0.31 to 0.76 for changes in stigma from baseline to 30-day follow-up in study 1 and from 0.13 to 0.47 for changes from baseline to postintervention in study 2. CONCLUSIONS The RCTs demonstrated the efficacy of brief videos, both traditional and selfie, in reducing illness-related stigma among young adults and adolescents and in increasing treatment-seeking intention among adolescents. Future studies should explore the effects of brief videos presented by social media influencers on mental health stigma and treatment engagement.
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Affiliation(s)
- Doron Amsalem
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Samantha E Jankowski
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Shannon Pagdon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Linda Valeri
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Lawrence H Yang
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - John C Markowitz
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Yuval Neria
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Bernice A Pescosolido
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Lisa B Dixon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Andrés Martin
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
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McCullock SP, Scrivano RM. The effectiveness of mental illness stigma-reduction interventions: A systematic meta-review of meta-analyses. Clin Psychol Rev 2023; 100:102242. [PMID: 36563518 DOI: 10.1016/j.cpr.2022.102242] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/24/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
The high prevalence of stigma toward mental illnesses contributes to the worsened health and quality of life for people with mental illnesses. Different stigmas (e.g., public, self) lead to social discrimination, social isolation, and reduce the likelihood that people with mental illnesses receive adequate treatment for their conditions. In response to this, numerous social interventions have been developed to help combat the spread of stigma. Subsequently, researchers have conducted meta-analyses to determine the effectiveness of different interventions for reducing stigma toward mental illness. To date, no efforts have been made to synthesize these meta-analyses to identify gaps in the stigma-reduction literature, assess the quality of extant literature, and to identify trends in programming efforts. The present study conducted a systematic meta-review of 19 meta-analyses, drawing from the Health Stigma and Discrimination Framework, to address these gaps. Results showed that the included meta-analyses were of relatively poor quality and that interventions primarily addressed either public or self-stigma, while overlooking other stigmas. Further, meta-analyses primarily assessed the effects of contact-promotion or educational intervention strategies. There was little evidence to suggest that interventions were effective longitudinally. Implications for future research and intervention development are discussed.
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Affiliation(s)
- Seth P McCullock
- Division on Addiction, Cambridge Health Alliance, Malden, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
| | - Rachel M Scrivano
- College of Social Work, The Ohio State University, Columbus, Ohio, USA.
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Branley-Bell D, Talbot CV, Downs J, Figueras C, Green J, McGilley B, Murphy-Morgan C. It's not all about control: challenging mainstream framing of eating disorders. J Eat Disord 2023; 11:25. [PMID: 36805761 PMCID: PMC9938956 DOI: 10.1186/s40337-023-00752-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/08/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND The concept of control has long been suggested as a central factor in eating disorder (ED) aetiology. The concept is now so mainstream that it risks being used in a potentially reductionist, stigmatising or otherwise harmful manner. In this paper, we explore and discuss our positions on the use of control-related terminology for EDs. METHODS The authors of this auto-ethnographic position paper include academic researchers, individuals with lived experience and clinicians (not mutually exclusive). In sharing our experiences and observations, we aim to raise awareness of the wider impacts that control framing can have on ED perceptions, treatment, recovery and individuals' lived experience. RESULTS We argue that although control can play a role in some ED experiences, an overemphasis upon this factor to the exclusion of other conceptualisations is not beneficial. CONCLUSIONS To mitigate against pathologisation of an individual, it is important to challenge a discourse that can lead to EDs being perceived as something 'wrong' with the individual, rather than a consequence of life events or other environmental influences. We identify priorities for the future for researchers, clinicians, policy makers and the wider public.
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Affiliation(s)
- Dawn Branley-Bell
- Department of Psychology, PaCT Lab, Northumbria University, Northumberland Building, City Campus, Newcastle Upon Tyne, NE1 8ST, UK.
| | | | - James Downs
- Patient Representative, Royal College of Psychiatrists, London, UK
| | | | - Jessica Green
- Leeds and York NHS Partnership Foundation Trust, Leeds, UK
| | - Beth McGilley
- Adjunct Faculty, University of Kansas School of Medicine-Wichita, Wichita, USA
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28
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Lyon RY, Schuster NM. Rate and Predictors of Patients with Chronic Pain Establishing Care with Pain Psychology Following Pain Physician Referral. PAIN MEDICINE 2023; 24:188-196. [PMID: 35861428 DOI: 10.1093/pm/pnac107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine, among patients with chronic pain who had received pain physician referral to pain psychology, the rate of establishing care and factors related to establishing care with pain psychology. DESIGN Retrospective study. SETTING Academic tertiary care center. SUBJECTS Patients from the University of California, San Diego (UCSD) Center for Pain Medicine. METHODS This was an institutional review board-approved, retrospective study of 150 consecutive referrals of unique patients from UCSD Pain Medicine to UCSD Pain Psychology. RESULTS Of 150 patients referred to pain psychology, 74 (49.3%) established care with pain psychology. Of 98 patients who had previously seen mental health services, 58 established care with pain psychology (59.2%; 95% confidence interval [CI]: 49% to 69%), whereas of 52 patients who had not previously seen mental health services, 16 established care with pain psychology (30.8%; 95% CI: 18% to 43%) (odds ratio [OR] 3.26; 95% CI: 1.60 to 6.66). In the patient subset with depression and/or anxiety, of 82 patients who had previously seen mental health services, 47 established care with pain psychology (57.3%; 95% CI: 47% to 68%), whereas of 20 patients who had not previously seen mental health services, three established care with pain psychology (15%; 95% CI: -1% to 31%) (OR 7.61; 95% CI: 2.07 to 28.01). Of 96 patients referred for general pain psychology evaluations, 43 established care (45%; 95% CI: 35% to 55%), whereas of 38 patients referred for preprocedural evaluation for an implantable device, 24 established care (63%; 95% CI: 48% to 78%). CONCLUSION Patients are significantly more likely to establish care with pain psychology if they have previously seen a mental health professional. This was even more marked among the patient subset with a history of depression and/or anxiety who had engaged in mental health services than among those with a history of depression and/or anxiety who had not engaged in mental health services. Whether referral was for general psychological evaluation or preprocedural evaluation for an implantable device did not significantly influence whether patients established care. Targeted interventions are needed to improve the likelihood of patients engaging with pain psychology services.
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Affiliation(s)
- Ronit Y Lyon
- Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA
| | - Nathaniel M Schuster
- Center for Pain Medicine, Department of Anesthesiology, University of California, San Diego, La Jolla, California, USA
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29
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Can Gür G, Yılmaz E. Effectiveness of Interventions in Reducing Substance-Related Stigma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Issues Ment Health Nurs 2023; 44:162-175. [PMID: 36725369 DOI: 10.1080/01612840.2022.2163439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to undertake a quantitative analysis to determine the effectiveness of interventions designed in reducing different types of stigma (self-stigma, social stigma, and structural stigma) for the substance use. This study followed the Cochrane Handbook for Systematic Reviews of Interventions guideline. This study followed the Cochrane Handbook for Systematic Reviews of Interventions guideline. Systematic searches were conducted in PubMed, Science Direct, Web of Science, Scopus, and MEDLINE. These electronic databases were searched research published in English from date of their inception to July 15, 2021. Randomized controlled trials that evaluated interventions on stigma associated with substance use were included. Studies should include at least one stigma outcome involving self-stigma, social stigma, or structural stigmatization. Ten randomized controlled studies were included. The overall Hedges'g for the interventions' impact on reducing stigma was 0.301, 95%CI = [-0.154- 0.755], p = 0.195, that there was no statistically significant difference. However, the meta-analysis showed that interventions had no significant impact on self-stigma [0.682, 95% CI=(-0.015-1.380), p = 0.055] and social stigma [0.198, 95% CI=(-1.271-0.876), p = 0.718] but had a small but significant impact in favor of the experimental group on reducing structural stigma [0.360 (95% CI= 0.156-0.564), p = 0.00]. According to subgroup analyses, there was no difference in the effects of stigma according to the type of intervention, the number of sessions, or the type of group. The interventions for reducing stigma related to substance use are promising. It seems to have a small but significant positive impact on structural stigma.
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Affiliation(s)
- Ganime Can Gür
- Department of Psychiatric Nursing, Faculty of Health Science, University of Pamukkale, Denizli, Turkey
| | - Emine Yılmaz
- Faculty of Nursing, Department of Psychiatric Nursing, University of İnönü, Malatya, Turkey
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30
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Wong EC, Torres VN, Martinez MO, Han B, Vue M, Derose KP. A parish-based multilevel cluster randomized controlled trial to reduce stigma and mental health treatment disparities among Latino communities. Contemp Clin Trials 2023; 125:107080. [PMID: 36621595 PMCID: PMC9918710 DOI: 10.1016/j.cct.2023.107080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/21/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
Latino communities within the U.S. are disproportionately affected by persistent, high levels of untreated mental illness. Limited mental health literacy, stigma, and cultural factors are major contributors to Latino mental health treatment disparities. Although Latino individuals may be reluctant to seek out mental health professionals, they often rely on religious congregations when confronted with mental illness. However, religious congregations report major obstacles to collaborating with the mental health sector including the lack of mental health training, staffing, and resources. Strategic partnerships between religious congregations and community-based organizations can be leveraged to target sources of Latino mental health treatment disparities. The National Alliance on Mental Illness (NAMI), the nation's largest grassroots mental health organization, has developed a host of programs tailored to the different needs and segments of the community affected by mental illness, including programs designed to address culturally diverse and faith-based communities. This cluster-randomized controlled trial leverages the collective resources of NAMI and the Diocese of San Bernardino to deliver and evaluate the effectiveness of a multi-level, parish-based, intervention to decrease stigma, increase mental health literacy, and improve access to mental health services among Latino parishioners. This study will enroll 1400 participants from 14 parishes that will be randomly assigned to receive the intervention immediately or a wait-list control condition. The intervention could enrich awareness of mental health issues, shape norms about mental illness, facilitate treatment access, and add support from religious congregations to target Latino mental health disparities using culturally and faith-based tailored approaches.
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Affiliation(s)
- Eunice C Wong
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States.
| | - Vanessa N Torres
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States; University of Massachusetts, Department of Health Promotion & Policy, School of Public Health and Health Sciences, 306 Arnold House, 715 N. Pleasant Street, Amherst, MA 01003, United States.
| | - Mario O Martinez
- Cedars-Sinai, Cancer Research Center for Health Equity, 700 N. San Vicente Blvd., PDC Green Bldg., 5th Floor, Suite G-599, West Hollywood, CA 90069, United States.
| | - Bing Han
- Diocese of San Bernardino, Office of Marriage & Family Life Ministry, 1201 E. Highland Avenue, San Bernardino, CA 92404, United States.
| | - Melen Vue
- Kaiser Permanente Research and Evaluation, 100 S Los Robles Ave #2, Pasadena, CA 91101, United States.
| | - Kathryn P Derose
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States; NAMI California, Vice President of Programs and Services, 425 University Avenue, #200, Sacramento, CA 95825, United States.
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31
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Fernandez DK, Singh S, Deane FP, Vella SA. Exploring Continuum and Categorical Conceptualisations of Mental Health and Mental Illness on Australian Websites: A Systematic Review and Content Analysis. Community Ment Health J 2023; 59:275-289. [PMID: 35994182 PMCID: PMC9859906 DOI: 10.1007/s10597-022-01005-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 06/27/2022] [Indexed: 01/25/2023]
Abstract
It is important to explore the types of conceptualisations and causes presented in online mental health promotion given the implications that these presentations may have on mental health stigma. This study systematically reviewed 92 Australian webpages focused on either mental health, mental illness, depression, or schizophrenia, to explore the types of conceptualisations and aetiologies presented. A minority of mental health and mental illness webpages (n = 8, 8.70%) explicitly presented continuum conceptualisations, with none providing explicit categorical conceptualisations. No depression or schizophrenia webpages presented explicit conceptualisations of any kind. All four webpage foci had a greater proportion of continuum than categorical conceptualisations. Moreover, both depression and schizophrenia webpages presented many mixed conceptualisations which included both continuum and categorical messaging. Most webpages mentioned biological and social causes equally across webpage foci. These findings suggest that Australian mental health websites predominantly present continuum conceptualisations of mental health and mental illness.
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Affiliation(s)
- Dominic K. Fernandez
- School of Psychology, University of Wollongong, North Wollongong, NSW 2522 Australia
| | - Saniya Singh
- School of Psychology, University of Wollongong, North Wollongong, NSW 2522 Australia
| | - Frank P. Deane
- School of Psychology, University of Wollongong, North Wollongong, NSW 2522 Australia
| | - Stewart A. Vella
- School of Psychology, University of Wollongong, North Wollongong, NSW 2522 Australia
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32
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Ng SM, Lu S, Wang A, Lo KC, Fok HK, Xie W, Li HY. Enhancing intergroup relationship between local and mainland college students in Hong Kong - an intensive contact-based intervention. CURRENT PSYCHOLOGY 2023; 42:1-21. [PMID: 36627951 PMCID: PMC9816015 DOI: 10.1007/s12144-022-04194-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
This study examined the efficacy of an intensive one-day intergroup contact intervention for two groups under tension: local and mainland Chinese college students in Hong Kong. The differential effects of contact intimacy at cognitive, interpersonal, and emotional levels in fostering changes in knowledge, attitude, and behavior were evaluated. Adopting a two-arm Randomized Controlled Trial (RCT) design, participants (N = 72) were randomly assigned to the intervention group that facilitated progressively higher levels of contact intimacy, or the control group that had limited level of contact intimacy. The results support the short-term intervention efficacy in enhancing outgroup knowledge, attitude, and behavior, with Cohen's d of 0.97, 0.60 and 0.30, respectively. Specifically, cognitive-level intergroup contact enhanced outgroup knowledge only. Adding interpersonal-level intergroup contact further enhanced outgroup attitude. Notably, adding emotional-level intergroup contact enhanced changes in all three domains: knowledge, attitude, and behavior. One-month maintenance effect was found in outgroup knowledge, with Cohen's d increased to 1.33.
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Affiliation(s)
- Siu-man Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Centre on Behavioral Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Shuang Lu
- School of Social Work, University of Central Florida, Orlando, FL United States
| | - Amenda Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Kai Chung Lo
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Hung Kit Fok
- Department of Psychology, The Chinese University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Weiyi Xie
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Hui Yun Li
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
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33
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Sportel BE, van Enthoven M, van Donkersgoed RJM, Kuis DJ, van de Giessen T, Lysaker PH, Hasson-Ohayon I, de Jong S, Boonstra N, Pijnenborg GHM. Self-stigma and cognitive insight in individuals at ultra-high risk for psychosis. Front Psychiatry 2023; 14:1154284. [PMID: 37124265 PMCID: PMC10133542 DOI: 10.3389/fpsyt.2023.1154284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Background Impaired cognitive insight and increased self-stigma have been consistently reported in individuals diagnosed with schizophrenia spectrum disorders, but little is known about its presence in individuals at ultra-high risk of developing a psychosis, although self-stigma is associated with transition.to psychosis. The current study examined whether self-stigma is already present in individuals at ultra-high risk of psychosis, and whether this is associated with impaired cognitive insight. Methods 184 participants were recruited divided over three groups, namely individuals diagnosed with a schizophrenia spectrum disorder (SSD; n = 92, 34% females), individuals at ultra-high risk for psychosis (UHR; n = 43, 59% females) and general population controls (GPC; n = 49, 27% females). All participants completed assessments on demographic information (gender, age, education), and cognitive insight. In addition, participants with SSD and individuals at UHR completed a questionnaire on self-stigma. Results The level of self-stigma did not differ between individuals at UHR and individuals diagnosed with SSD. Cognitive insight also did not differ significantly between the three groups, but the subscale self-reflection differed between the three groups [F(2,184) = 4.20, p = 0.02], with the UHR and SSD groups showing more self-reflection. Pearson's correlation analyses showed that in individuals at UHR total cognitive insight and its self-reflection subscale were significantly associated with the alienation subscale of self-stigma, and in individuals with SSD self-certainty subscale of cognitive insight was significantly associated with stereotype endorsement. Conclusion Findings show that self-stigma was already present in the UHR phase, to a similar degree as in individuals with a diagnosis of a SSD, and is thus not dependent of previous experience of having a label of SSD. Cognitive insight in individuals at UHR of psychosis appears to be intact, but individuals at UHR showed more self-reflectiveness, and individuals at risk with high cognitive insight also experience high levels of self-stigma. Overall findings from our study suggest that pre-emptive interventions targeting self-stigma, while considering cognitive insight, are needed early on in manifestation of psychotic illness, preferably already in the UHR phase.
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Affiliation(s)
- Bouwina Esther Sportel
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- *Correspondence: Bouwina Esther Sportel,
| | - Mirjam van Enthoven
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
| | - Rozanne J. M. van Donkersgoed
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Daan Jan Kuis
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
| | - Tara van de Giessen
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
| | - Paul H. Lysaker
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | | | - Nynke Boonstra
- KieN Early Intervention Service, Leeuwarden, Netherlands
- Research Group Care and Innovation in Psychiatry, NHL Stenden University for Applied Sciences, Leeuwarden, Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gerdina H. M. Pijnenborg
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
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34
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Leung T, Okumu M, Kortenaar JL, Gittings L, Khan N, Hakiza R, Kibuuka Musoke D, Nakitende A, Katisi B, Kyambadde P, Khan T, Lester R, Mbuagbaw L. Mobile Health-Supported Virtual Reality and Group Problem Management Plus: Protocol for a Cluster Randomized Trial Among Urban Refugee and Displaced Youth in Kampala, Uganda (Tushirikiane4MH, Supporting Each Other for Mental Health). JMIR Res Protoc 2022; 11:e42342. [PMID: 36480274 PMCID: PMC9782374 DOI: 10.2196/42342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although mental health challenges disproportionately affect people in humanitarian contexts, most refugee youth do not receive the mental health support needed. Uganda is the largest refugee-hosting nation in Africa, hosting over 1.58 million refugees in 2022, with more than 111,000 living in the city of Kampala. There is limited information about effective and feasible interventions to improve mental health outcomes and mental health literacy, and to reduce mental health stigma among urban refugee adolescents and youth in low- and middle-income countries (LMICs). Virtual reality (VR) is a promising approach to reduce stigma and improve mental health and coping, yet such interventions have not yet been tested in LMICs where most forcibly displaced people reside. Group Problem Management Plus (GPM+) is a scalable brief psychological transdiagnostic intervention for people experiencing a range of adversities, but has not been tested with adolescents and youth to date. Further, mobile health (mHealth) strategies have demonstrated promise in promoting mental health literacy. OBJECTIVE The aim of this study is to evaluate the feasibility and effectiveness of two youth-tailored mental health interventions (VR alone and VR combined with GMP+) in comparison with the standard of care in improving mental health outcomes among refugee and displaced youth aged 16-24 years in Kampala, Uganda. METHODS A three-arm cluster randomized controlled trial will be implemented across five informal settlements grouped into three sites, based on proximity, and randomized in a 1:1:1 design. Approximately 330 adolescents (110 per cluster) are enrolled and will be followed for approximately 16 weeks. Data will be collected at three time points: baseline enrollment, 8 weeks following enrollment, and 16 weeks after enrollment. Primary (depression) and secondary outcomes (mental health literacy, attitudes toward mental help-seeking, adaptive coping, mental health stigma, mental well-being, level of functioning) will be evaluated. RESULTS The study will be conducted in accordance with CONSORT (Consolidated Standards of Reporting Trials) guidelines. The study has received ethical approval from the University of Toronto (#40965; May 12, 2021), Mildmay Uganda Research Ethics Committee (MUREC-2021-41; June 24, 2021), and Uganda National Council for Science & Technology (SS1021ES; January 1, 2022). A qualitative formative phase was conducted using focus groups and in-depth, semistructured key informant interviews to understand contextual factors influencing mental well-being among urban refugee and displaced youth. Qualitative findings will inform the VR intervention, SMS text check-in messages, and the adaptation of GPM+. Intervention development was conducted in collaboration with refugee youth peer navigators. The trial launched in June 2022 and the final follow-up survey will be conducted in November 2022. CONCLUSIONS This study will contribute to the knowledge of youth-tailored mental health intervention strategies for urban refugee and displaced youth living in informal settlements in LMIC contexts. Findings will be shared in peer-reviewed publications, conference presentations, and with community dissemination. TRIAL REGISTRATION ClinicalTrials.gov NCT05187689; https://clinicaltrials.gov/ct2/show/NCT05187689. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42342.
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Affiliation(s)
| | - Moses Okumu
- School of Social Work, University of Illinois, Urban-Champaign, IL, United States.,School of Social Sciences, Uganda Christian University, Mukono, Uganda
| | - Jean-Luc Kortenaar
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lesley Gittings
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada.,Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Naimul Khan
- Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Robert Hakiza
- Young African Refugees for Integral Development, Kampala, Uganda
| | | | | | - Brenda Katisi
- Young African Refugees for Integral Development, Kampala, Uganda
| | - Peter Kyambadde
- National AIDS and STI Control Programme, Ministry of Health, Kampala, Uganda.,Most At Risk Population Initiative, Mulago Hospital, Kampala, Uganda
| | - Torsum Khan
- Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Richard Lester
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Department of Anesthesia, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada.,Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon.,Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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35
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Thornicroft G, Sunkel C, Alikhon Aliev A, Baker S, Brohan E, El Chammay R, Davies K, Demissie M, Duncan J, Fekadu W, Gronholm PC, Guerrero Z, Gurung D, Habtamu K, Hanlon C, Heim E, Henderson C, Hijazi Z, Hoffman C, Hosny N, Huang FX, Kline S, Kohrt BA, Lempp H, Li J, London E, Ma N, Mak WWS, Makhmud A, Maulik PK, Milenova M, Morales Cano G, Ouali U, Parry S, Rangaswamy T, Rüsch N, Sabri T, Sartorius N, Schulze M, Stuart H, Taylor Salisbury T, Vera San Juan N, Votruba N, Winkler P. The Lancet Commission on ending stigma and discrimination in mental health. Lancet 2022; 400:1438-1480. [PMID: 36223799 DOI: 10.1016/s0140-6736(22)01470-2] [Citation(s) in RCA: 116] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/19/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Graham Thornicroft
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK.
| | | | - Akmal Alikhon Aliev
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Sue Baker
- Mind international, London, UK; Changing Minds Globally, London, UK
| | - Elaine Brohan
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | | | - Kelly Davies
- Centre for Implementation Science, King's College London, London UK
| | - Mekdes Demissie
- College of Health Sciences and Medicine, School of Nursing and Midwifery, Haramaya University, Ethiopia; Centre for Innovative Drug Development and Therapeutic Studies for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia
| | | | - Wubalem Fekadu
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Petra C Gronholm
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | - Zoe Guerrero
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Dristy Gurung
- Centre for Implementation Science, King's College London, London UK; Transcultural Psychosocial Organization (TPO), Kathmandu Nepal
| | - Kassahun Habtamu
- Addis Ababa University, School of Psychology, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; WHO Collaborating Centre for Mental Health Research and Training, King's College London, London UK; Department of Psychiatry, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva Heim
- Institut de Psychologie, University of Lausanne, Lausanne, Switzerland
| | - Claire Henderson
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | | | | | - Nadine Hosny
- Institut de Psychologie, University of Lausanne, Lausanne, Switzerland
| | | | | | - Brandon A Kohrt
- Division of Global Mental Health, George Washington University, Washington DC, USA
| | - Heidi Lempp
- Institute of Psychiatry, Psychology and Neuroscience, and Academic Department of Rheumatology, King's College London, London UK
| | - Jie Li
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Ning Ma
- Institute of Mental Health, Peking University, Beijing, China
| | - Winnie W S Mak
- Department of Psychology, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Akerke Makhmud
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | - Pallab K Maulik
- George Institute for Global Health, New Delhi, India; University of New South Wales, Sydney, NSW, Australia
| | - Maria Milenova
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | | | - Uta Ouali
- Razi Hospital and El Manar Medical School, University of Tunis, La Manouba, Tunisia
| | - Sarah Parry
- South London and the Maudsley NHS Foundation Trust, London, UK
| | | | - Nicolas Rüsch
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany; Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Taha Sabri
- Taskeen Health Initiative, Karachi, Pakistan
| | - Norman Sartorius
- Association for the Improvement of Mental health Programs, Geneva, Switzerland
| | | | | | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | - Norha Vera San Juan
- Health Service and Population Research Department, King's College London, London UK
| | - Nicole Votruba
- and Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Petr Winkler
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
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36
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Poulgrain JW, Bremner NM, Zimmerman H, Jao CW, Winter T, Riordan BC, Bizumic B, Hunter J, Scarf D. Why So Serious? An Attempt to Mitigate the Short-Term Harmful Effects of the Film Joker on Prejudice toward People with Mental Illness. Behav Sci (Basel) 2022; 12:bs12100384. [PMID: 36285953 PMCID: PMC9598699 DOI: 10.3390/bs12100384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
The media perpetuates many harmful stereotypes about people with mental illness. In two studies, we demonstrate the impact of negative media portrayals of mental illness on prejudice and attempt to mitigate these negative effects. Specifically, in Study 1, participants watched the movie Joker, a recent film which associates mental illness with violent behavior, or a control film (Terminator). Participants completed the Prejudice towards People with Mental Illness (PPMI) scale before and after viewing their respective films. The PPMI consists of four dimensions: fear/avoidance (i.e., wanting to avoid people with mental illness), malevolence (i.e., viewing people with mental illness as inferior), authoritarianism (i.e., preference for control over people with mental illness), and unpredictability (i.e., the behavior of people with mental illness is unreliable). We hypothesized that participants who watched the film Joker would display an increase in their fear/avoidance of people with mental illness and their support for authoritarian approaches to their treatment. Consistent with these hypotheses, participants who viewed Joker displayed a significant increase in the fear/avoidance and authoritarian subscales of the PPMI, relative to participants that watched Terminator. In Study 2, in an attempt to mitigate the impact of Joker on prejudice towards people with mental illness, directly after the film we displayed educational and counter-stereotypical statements on-screen that challenged the view that people with mental illness are violent. A control group viewed Joker without these statements. Identical to Study 1, all participants completed the PPMI scale before and after viewing the film. We hypothesized that participants who viewed Joker with the statements would display lower prejudice relative to the control condition. Unfortunately, participants in the experimental and control conditions displayed a comparable increase in prejudice. Together, these studies confirm the negative effect of media portrayals of mental illness (as depicted in Joker) and demonstrate that these effects are not easily mitigated.
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Affiliation(s)
| | | | - Hannah Zimmerman
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
| | - Chia-Wei Jao
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
| | - Taylor Winter
- Department of Psychology, Victoria University of Wellington, Wellington 6140, New Zealand
| | | | - Boris Bizumic
- Research School of Psychology, Australian National University, Canberra 2601, Australia
| | - John Hunter
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
| | - Damian Scarf
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
- Correspondence:
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37
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Magliano L. Bringing Psychology Students Closer to People with Schizophrenia at Pandemic Time: A Study of a Distance Anti-stigma Intervention With In-presence Opportunistic Control Group. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2022; 10:1-13. [PMID: 36217317 PMCID: PMC9534736 DOI: 10.1007/s40737-022-00308-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022]
Abstract
Psychology students are a target population to increase the likelihood that Persons With Schizophrenia (PWS) will receive evidence-based psycho-social interventions in the future. The willingness of future psychologists to care for PWS can be supported through anti-stigma educational interventions. During the pandemic, university education was delivered largely at-distance, which was later combined with in-presence education. This study explored whether an At-Distance Educational Intervention (ADEI), addressing stigma in schizophrenia via scientific evidence and testimony: would improve psychology students' views of PWS, at the one-month post intervention re-assessments; would be more effective of the same In-Presence Educational Intervention (IPEI). ADEI was delivered online to students of two Master's degrees in Psychology at the University of Campania "Luigi Vanvitelli", Caserta, Italy. IPEI was administered to a similar group of 76 students in the pre-pandemic era. Participants completed an anonymous questionnaire about their views on schizophrenia before the intervention (two three-hour sessions one week apart) and one month after its completion. Compared to their pre-intervention assessments, at post-intervention reassessments the 65 ADEI students were: more confident in the recovery and the usefulness of psychological therapies; surer of the PWS awareness and capability to report health problems to professionals; more skeptical about PWS dangerousness, social distance, and affective difficulties; more uncertain on the opportunity to discriminate PWS in hospital and psychology practices. ADEI was more effective than IPEI in five of the ten dimensions analyzed and similarly effective in the remaining others. ADEI may represent a valuable alternative to IPEI for improving future psychologists' view of PWS. Supplementary Information The online version contains supplementary material available at 10.1007/s40737-022-00308-1.
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Affiliation(s)
- Lorenza Magliano
- Department of Psychology, Lorenza Magliano, University of Campania “Luigi Vanvitelli”, Viale Ellittico 31, 81100 Caserta, Italy
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38
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Genrich M, Angerer P, Worringer B, Gündel H, Kröner F, Müller A. Managers' Action-Guiding Mental Models towards Mental Health-Related Organizational Interventions-A Systematic Review of Qualitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12610. [PMID: 36231909 PMCID: PMC9566424 DOI: 10.3390/ijerph191912610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
Research indicates that managers' active support is essential for the successful implementation of mental health-related organizational interventions. However, there is currently little insight into what subjective beliefs and perceptions (=mental models) make leaders support such interventions. To our knowledge, this is the first qualitative systematic review of this specific topic, and it considers 17 qualitative studies of managers' perspective. Based on the theory of planned behavior, this review provides an overview of three action-guiding factors (attitudes, organizational norms and behavioral control) that can serve as starting points for engaging managers in the implementation of mental health-related measures and ensuring their success. Our results provide evidence that supportive organizational norms may particularly help to create a common sense of responsibility among managers and foster their perceived controllability with respect to changing working conditions. Our study thus contributes to a more differentiated understanding of managers' mental models of health-related organizational interventions.
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Affiliation(s)
- Melanie Genrich
- Institute of Psychology, Work & Organizational Psychology, University of Duisburg-Essen, 45141 Essen, Germany
| | - Peter Angerer
- Institute for Occupational, Social & Environmental Medicine, Centre for Health and Society, Medical Faculty, Düsseldorf University, 40225 Düsseldorf, Germany
| | - Britta Worringer
- Institute for Occupational, Social & Environmental Medicine, Centre for Health and Society, Medical Faculty, Düsseldorf University, 40225 Düsseldorf, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89081 Ulm, Germany
| | - Friedrich Kröner
- Institute of Psychology, Work & Organizational Psychology, University of Duisburg-Essen, 45141 Essen, Germany
| | - Andreas Müller
- Institute of Psychology, Work & Organizational Psychology, University of Duisburg-Essen, 45141 Essen, Germany
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39
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Suen YN, Lam OBC, Chan KT, Wong THM, Lui SYS, Chan YYV, Lam HY, Wong MYS, Hui LMC, Lee HME, Chang WC, Chan KWS, Chen YHE. A multifaceted approach in promoting positive mental health culture in Hong Kong secondary schools: The Mindshift educational networking programme. Early Interv Psychiatry 2022; 16:1094-1101. [PMID: 34841711 DOI: 10.1111/eip.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 10/09/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022]
Abstract
AIM Many young people with mental health problems refuse to seek help because of stigma and leave the problem untreated. Previous research suggests that contact interventions with education could improve the stigma of mental illness in young people, thereby encouraging help-seeking in distress. The current study examined the effectiveness of a multifaceted programme, the Mindshift educational networking programme (MENP), in promoting a positive mental health culture in Hong Kong secondary schools. METHODS The MENP provided activities at school, teacher and student levels to 14 Hong Kong secondary schools. School activities included visits, mental health talks and support for capstone projects. While teachers participated in workshops and regional seminars, students received ambassador training workshops, contact opportunities with people with psychosis and attachment programmes. The impact of MENP was evaluated by changes in students' knowledge, attitudes and behaviours toward people with psychosis and mental illness before and after the programme, as well as by teachers' feedback on the programme. RESULTS This study analysed data from 55 students and 20 teachers. It was found that the MENP improved students' knowledge of mood symptoms (p = .03), acceptance of people with psychosis (p = .04) and intended behaviour toward people with mental illness (p = .02). The feedback of the teachers on the programme was positive. CONCLUSIONS The results support the application of the multifaceted approach to promote a positive mental health culture in schools. The findings call on the government to implement the programme in schools in Hong Kong by providing financial support to relevant organizations.
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Affiliation(s)
- Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | | | - Kai Tai Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | | | - Sai Yu Simon Lui
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | | | - Hoi Ying Lam
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | | | | | - Ho Ming Edwin Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong, China.,State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Wing Chung Chang
- Department of Psychiatry, University of Hong Kong, Hong Kong, China.,State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Kit Wa Sherry Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong, China.,State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Yu Hai Eric Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, China.,State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
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Piras M, Perra A, Gureje O, Preti A, Carta MG. The Current Quality of Web-Based Information on the Treatment of Bipolar Disorder: A Systematic Search. J Clin Med 2022; 11:jcm11185427. [PMID: 36143075 PMCID: PMC9501527 DOI: 10.3390/jcm11185427] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 11/21/2022] Open
Abstract
Background: An important aspect of managing chronic disorders like bipolar disorder is to have access to relevant health information. This study investigates and compares the quality of information on the treatments of bipolar disorder that is available on English websites, as an international language, and on Italian websites, as a popular local language. Methods: A systematic review search was obtained from four search engines. We excluded unrelated materials, scientific papers, and duplicates. We analyzed popularity with PageRank; technological quality with Nibbler; readability with the Flesh Reading Ease test and Gulpease index; quality of information with the DISCERN scale, the JAMA benchmark criteria, and on the extent of adherence to the HONCode. Results: 35 English and 31 Italian websites were included. The English websites were found to have a higher level of quality information and technological quality than the Italian ones. Overall, the websites were found to be difficult to read, requiring a high level of education. Conclusions: These results can be important to inform guidelines for the improvement of health information and help users to reach a higher level of evidence on the websites. Users should find the benefits of treatment, support for shared decision-making, the sources used, the medical editor’s supervision, and the risk of postponing treatment.
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Affiliation(s)
- Martina Piras
- Innovation Sciences and Technologies, University of Cagliari, 09124 Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Alessandra Perra
- Innovation Sciences and Technologies, University of Cagliari, 09124 Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
- Correspondence: ; Tel.: +39-348-144-4501
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan 200285, Nigeria
| | - Antonio Preti
- Department of Neuroscience, University of Turin, 10126 Turin, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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Mistry SK, Ali ARMM, Yadav UN, Huda MN, Rahman MM, Saha M, Rahman MA, Lim D, Ghimire S. Stigma toward people with COVID-19 among Bangladeshi older adults. Front Public Health 2022; 10:982095. [PMID: 36176510 PMCID: PMC9514800 DOI: 10.3389/fpubh.2022.982095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/08/2022] [Indexed: 01/25/2023] Open
Abstract
The onset of the coronavirus disease (COVID-19) pandemic and its overwhelming physical and mental health burden can result in stigmatization toward the disease and those affected. This study aimed to measure the prevalence of COVID-19-related stigma and its associated factors among older people in Bangladesh. This cross-sectional study was conducted among 1,045 Bangladeshi older adults aged 60 years and above through telephone interviews in September 2021. The outcome was measured using an eight-point Stigma Scale, adapted to the Bengali language. Level of stigma was indicated by the cumulative score of the eight-items, ranging from 0 to 8, with a higher score indicating a higher level of stigma. On average, participants had stigmas on three of the eight items, and 62.6% had a high stigma score. The most prevalent stigmas were as follows: COVID-19 is a punishment from God (79.3%), patients with previous COVID-19 must be isolated (67.3%), and people infected with COVID-19 did not meet hygiene standards (63.9%). Participants who lived in rural areas (β: 0.67, 95% CI: 0.39 to 0.95) and who perceived needing additional care during the pandemic (β: 0.35, 95% CI: 0.09 to 0.60) had a higher average stigma score, whereas stigma scores were lower among unemployed/retired participants (β: -0.22, 95% CI: -0.45 to 0.00). The study findings suggest implementing interventions to raise awareness through appropriate health literacy interventions and mass media campaigns.
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Affiliation(s)
- Sabuj Kanti Mistry
- Department of Health Research, ARCED Foundation, Dhaka, Bangladesh
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- BRAC James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | | | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Md. Nazmul Huda
- Department of Health Research, ARCED Foundation, Dhaka, Bangladesh
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbeltown, NSW, Australia
| | - Md. Mahmudur Rahman
- Research, Monitoring and Information Management Organization/Institutions, Deep Eye Care Foundation, Rangpur, Bangladesh
| | - Manika Saha
- Department of Human-Centred Computing, Faculty of Information Technology, Monash University, Clayton, VIC, Australia
| | | | - David Lim
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbeltown, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbeltown, NSW, Australia
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, United States
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Walsh D, Foster J. Charting an Alternative Course for Mental Health-Related Anti-Stigma Social and Behaviour Change Programmes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10618. [PMID: 36078334 PMCID: PMC9518073 DOI: 10.3390/ijerph191710618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Mental health-related anti-stigma strategies are premised on the assumption that stigma is sustained by the public's deficiencies in abstract professional knowledge. In this paper, we critically assess this proposition and suggest new directions for research. Our analysis draws on three data sets: news reports (N = 529); focus groups (N = 20); interviews (N = 19). In each social context, we explored representations of mental health and illness in relation to students' shared living arrangements, a key group indicated for mental health-related anti-stigma efforts. We analysed the data using term-frequency inverse-document frequency (TF-IDF) models. Possible meanings indicated by TF-IDF modelling were interpreted using deep qualitative readings of verbatim quotations, as is standard in corpus-based research approaches to health and illness. These results evidence the flawed basis of dominant mental health-related anti-stigma campaigns. In contrast to deficiency models, we found that the public made sense of mental health and illness using dynamic and static epistemologies and often referenced professionalised understandings. Furthermore, rather than holding knowledge in the abstract, we also found public understanding to be functional to the social context. In addition, rather than being agnostic about mental health-related knowledge, we found public understandings are motivated by group-based identity-related concerns. We will argue that we need to develop alternative anti-stigma strategies rooted in the public's multiple contextualised sense-making strategies and highlight the potential of engaging with ecological approaches to stigma.
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Affiliation(s)
- Daniel Walsh
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AB, UK
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Sreeram A, Cross WM, Townsin L. Anti-stigma initiatives for mental health professionals-A systematic literature review. J Psychiatr Ment Health Nurs 2022; 29:512-528. [PMID: 35500153 DOI: 10.1111/jpm.12840] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Negative attitudes towards mental illness lead to the formation of stigma. Stigma prevents the recovery of people diagnosed with mental illness. There is evidence of stigmatic attitudes towards mental ill health among mental health professionals. Anti-stigma initiatives, such as education and training, may be effective in enhancing or maintaining positive attitudes towards mental illness among mental health professionals. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Education and training that is designed and delivered around a specific mental health diagnosis or condition appears an appropriate strategy that could benefit mental health professionals to develop a deeper appreciation and understanding of mental ill health and its impacts on individuals. Consumer involvement in the education and training of mental health professionals regarding the stigma of mental illness is recommended; however, this is an under-explored area of investigation. There is a weak evidence base regarding the long-term sustainability of effects from anti-stigma education and training. This should be addressed via further research in future. WHAT ARE THE IMPLICATIONS FOR PRACTICES?: Anti-stigma initiatives can support mental health professionals to develop stigma-free, recovery-oriented practices in their work. Further, such initiatives can improve the provision of evidence-based quality care for the consumers, facilitating their recovery. ABSTRACT: Introduction Despite an increasing focus on stigma, evidence shows prejudicial attitudes towards mental illness among mental health professionals still exist. It is suggested that anti-stigma initiatives can aid in enhancing the attitudes of mental health professionals. However, research on initiatives targeting stigma of mental illness among mental health professionals is limited. Aim To identify and analyse scientific literature pertaining to the effectiveness of anti-stigma initiatives regarding mental ill health among mental health professionals. Method A systematic literature review was performed using the databases MEDLINE, CINAHL, PsycINFO, PubMed, Scopus, Google Search engine and Google Scholar. The papers were limited to English language, published in peer-reviewed journals with full-text articles available and published between the years 2008 and 2020 to understand the most recent trends in the attitudes of mental health professionals including nurses. The Population, Intervention, Comparison and Outcome (PICO) strategy was used to identify papers meeting the inclusion criteria. Results A total of 439 papers were identified. However, papers not meeting the inclusion criteria were excluded from selection. Three appraisers reviewed the selected papers individually using the Joanna Briggs Institute [JBI] critical appraisal tool. Finally, eight unanimously accepted papers were included in the systematic review. Several effective anti-stigma initiatives were identified through the review, and these had positive impacts on mental health professionals' attitudes towards mental illness, for at least a short period. It was identified that contact-based interventions are relevant and effective although the involvement of consumers and caregivers in the design and delivery of interventions was not explicitly addressed in detail in studies included in the review. Education strategies tailored for specific mental illness may be more appropriate, rather than approaches that refer to mental illness in general. Conclusions This review shows the evidence of pessimistic attitudes towards mental illness persists among mental health professionals. Anti-stigma initiatives identified in the selected papers were effective in changing these attitudes. Future research should be focused on the effectiveness of contact-based interventions and understanding the longer-term effects of the interventions among homogeneous groups. Full consideration of the varying level of clinical experience and expertise in mental health should guide the development and implementation of anti-stigma initiatives in this context. Implications for practice Anti-stigma interventions can have a positive impact on mental health professionals' knowledge, attitudes and supportive caring for people diagnosed with mental illness. Such anti-stigma interventions may meaningfully support stakeholders to address the impact of negative attitudes on the physical and mental health status of people diagnosed with mental illness. With sustained leadership, effort and reinforcement, it is possible to create workplace cultures that prioritize stigma-free and recovery-oriented behaviours and practices within mental health services.
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Affiliation(s)
- Anju Sreeram
- Federation University, Berwick Campus, Melbourne, Vic., Australia
| | - Wendy M Cross
- Federation University Australia, Ballarat, Vic., Australia
| | - Louise Townsin
- Federation University, Berwick Campus, Melbourne, Vic., Australia.,Torrens University, Australia, Adelaide, SA, Australia
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Raj CT. The effectiveness of mental health disorder stigma-reducing interventions in the healthcare setting: An integrative review. Arch Psychiatr Nurs 2022; 39:73-83. [PMID: 35688548 DOI: 10.1016/j.apnu.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 03/12/2022] [Accepted: 03/13/2022] [Indexed: 11/24/2022]
Abstract
Individuals with mental health disorders frequently seek medical treatment in health care settings other than a mental health facility. However, mental health disorder stigmatization is prevalent in the healthcare setting across the globe. Stigmatizing attitudes remain widespread among healthcare professionals who are responsible for delivering patient-centered, quality care. Stigma in the healthcare setting can undermine effective diagnosis, therapy, and optimum health outcomes. Addressing stigma is critical to delivering quality health care in both developed and developing countries. Therefore, it is important to deliver successful anti-stigma education, along with practical strategies, to reduce the stigma of mental health disorders among healthcare professionals. An integrative review was conducted to identify the effectiveness of various interventions used in 10 different countries globally to reduce the stigma of mental health disorders in the healthcare setting.
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Affiliation(s)
- Catherine T Raj
- Department of Nursing, Liberty University, United States of America.
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Enhancing mental health literacy in obsessive-compulsive disorder and reducing stigma via smartphone: A randomized controlled trial protocol. Internet Interv 2022; 29:100560. [PMID: 35874968 PMCID: PMC9305319 DOI: 10.1016/j.invent.2022.100560] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/23/2022] [Accepted: 07/05/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a disabling disorder that can be successfully treated. However, individuals with OCD do not seek or delay seeking treatment. This delay may be explained by poor mental health literacy and stigmatizing attitudes toward OCD in community. In order to work on these variables, a gamified mental health mobile application (app) called esTOCma has been developed. The purpose of this study is to describe the protocol for a study to test the efficacy of esTOCma, increasing mental health literacy and help-seeking intention, reducing the stigmatizing attitudes and social distance suffered by people with OCD, as well as the distress associated with obsessive-compulsive symptoms. METHODS A randomized controlled trial with a crossover design with two conditions (immediate-use App group versus delayed-use App group) will be conducted on a non-clinical adult sample of the community of a minimum size of 200 participants. Participants in the immediate-use App group will start using the app at baseline until completion (10 days); whereas participants in the delayed-use App group will wait 10 days, and then start using the app until completion (10 days). The outcomes will be measured at four assessment points (baseline; 10 days from baseline; and 20 days from baseline; and after 3 months). The following instruments will be administered: Attribution Questionnaire, General Help-Seeking Questionnaire, Social Distance Scale, Mental Health Literacy, Psychoeducation Questionnaire, Social Desirability Scale, Single-Item Self-esteem Scale, and Obsessive-Compulsive Inventory-Revised. DISCUSSION This protocol presents the first study to describe a randomized control trial of a mental health app focused on changing mental health literacy, stigmatizing attitudes, social distance and help-seeking intention associated with OCD. An app intervention of these characteristics is especially relevant nowadays as the COVID-19 pandemic has increased obsessive-compulsive symptoms and severity. An improvement in general knowledge about OCD and a reduction in stigma could be associated with earlier OCD detection and an increase in help-seeking intention, which could result in greater wellbeing. Moreover, normalizing intrusions and knowledge about the cognitive OCD model could serve as a protective variable in vulnerable individuals. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04777292. Registered February 23, 2021, https://clinicaltrials.gov/ct2/show/NCT04777292.
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A situational analysis of primary health care centers in Brazil: challenges and opportunities for addressing mental illness and substance use-related stigma. Prim Health Care Res Dev 2022; 23:e37. [PMID: 35775359 PMCID: PMC9309753 DOI: 10.1017/s1463423622000251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: The detrimental impact of stigma toward people with mental illness and substance use problems (MISUP) is well documented. However, studies focusing on stigma reduction in Latin American primary health care (PHC) contexts are limited. This situational analysis incorporating a socioecological framework aims to provide a comprehensive understanding of MISUP-related stigma in PHC centers in Brazil. The objectives of this analysis are twofold: (1) to understand the current mental health and substance use service delivery context and (2) identify challenges and opportunities for addressing MISUP-related stigma in PHC centers in Ribeirão Preto, Brazil. Methods: Environmental scans of four Family Health Units were conducted in early 2018 to explore population needs and service delivery for individuals with MISUP. In addition, a symposium was organized in October 2018 to consult with diverse stakeholders and gather local perspectives about MISUP-related stigma conveyed in PHC settings. NVivo 12 software was used to conduct a thematic analysis of the qualitative data collected from the environmental scans and the symposium consultation. Results: Themes identified at the national level in the socioecological framework indicate that political support for national policies related to reducing stigma is limited, particularly regarding social inclusion and the decentralization of mental health services. Themes at the regional, organizational, and interpersonal levels include insufficient mental health expertise and the limited involvement of those with lived experience in decision-making. Suggestions for stigma interventions were provided, including increased contact with individuals with lived experience outside of client-patient interactions, capacity building for professionals, and public education campaigns. Conclusion: Increased government support, capacity building, and promoting social inclusion will provide opportunities to reduce stigma and reach marginalized populations. These findings will assist with addressing current gaps in PHC mental health service provision and may inform anti-stigma strategies for Brazil and other Latin American low- and middle-income countries.
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Bacsu JD, Cammer A, Ahmadi S, Azizi M, Grewal KS, Green S, Gowda-Sookochoff R, Berger C, Knight S, Spiteri RJ, O'Connell ME. Examining Twitter Discourse on Dementia during Alzheimer’s Awareness Month in Canada: Infodemiology Study (Preprint). JMIR Form Res 2022; 6:e40049. [DOI: 10.2196/40049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
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Parry S, Eve Z, Myers G. Exploring the Utility and Personal Relevance of Co-Produced Multiplicity Resources with Young People. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:427-439. [PMID: 35600531 PMCID: PMC9120276 DOI: 10.1007/s40653-021-00377-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 06/15/2023]
Abstract
Multiplicity, the experience of more than one self in the body, is an under-researched area of young people's mental health. The aim of this study was to explore the perspectives of experts-by-experience within a community sample regarding two specific resources: a co-produced self-help guide about multiplicity for adolescents, and a set of guidelines for supporting someone who identifies as 'multiple'. 34 participants (Mage= 22.06, 2.26 SD; 15F, 1M, 18NBG) completed an online survey consisting of open-ended and Likert scale questions to assess the language, utility, transferability and therapeutic impact of the materials. Descriptive statistics and a Foucauldian-informed Narrative Analysis were employed to analyse responses, producing a summary of utility and two narrative chapters. The emergent chapters, 'Breaking the Stigma' and 'Recognising the Many', highlight the need for greater understanding and awareness of multiplicity, with psychoeducation materials viewed as helpful. Inclusive language can reduce stigma and normalise multiplicity as a response to trauma. With greater understanding, practitioners and researchers can collaborate with young people through trauma wise care, providing multiplicity sensitive language and support. Overall, the term 'parts' was viewed as problematic by the participants as it could imply the plural system is not coexisting as a whole. Additionally, opinions varied as to how much diagnostic language could and should be used to describe multiplicity; linguistically and conceptually. Importantly, compassion was seen as particularly essential for younger selves within the system; older in their years and presence, but often more vulnerable within the societies in which the system resides.
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Affiliation(s)
- Sarah Parry
- Department of Psychology, Manchester Metropolitan University, Brooks Building, Manchester, M15 6GX UK
| | - Zarah Eve
- Department of Psychology, Manchester Metropolitan University, Brooks Building, Manchester, M15 6GX UK
| | - Gemma Myers
- Department of Psychology, Manchester Metropolitan University, Brooks Building, Manchester, M15 6GX UK
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Barriers to accessing psycho-oncological support in head and neck cancer: A qualitative exploration of healthcare professionals’ perspectives. Eur J Oncol Nurs 2022; 58:102145. [DOI: 10.1016/j.ejon.2022.102145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 12/24/2022]
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50
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Best MW, Bowie CR. Social exclusion in psychotic disorders: An interactional processing model. Schizophr Res 2022; 244:91-100. [PMID: 35640357 DOI: 10.1016/j.schres.2022.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/11/2022] [Accepted: 05/18/2022] [Indexed: 11/28/2022]
Abstract
Psychotic disorders are among the most highly stigmatized mental disorders, and individuals with psychosis experience significant exclusion from the community. Stigma reduction programs have done little to reduce social exclusion of individuals with psychosis, and there are significant limitations to the traditional stigma model as it applies to social exclusion. Herein, we present the Interactional Processing Model (IPM) of social exclusion towards individuals with psychosis. The IPM considers social exclusion to be the result of two interacting pathways with additional consideration for a feedback loop through which social exclusion sets in motion natural behavioural responses of individuals with psychosis that inadvertently perpetuates exclusion. The IPM considers initial social exclusion to be the result of an interaction between these two pathways. The first path aligns with the traditional stigma model and consists of the community becoming aware that an individual is diagnosed with a psychotic disorder and then excluding the individual based on pre-existing, generalized knowledge about the disorder. The second path to exclusion involves the observation of atypical behaviours from the individual, and generation of an individualized exclusion response. We provide initial empirical support for the IPM of social exclusion, outline testable hypotheses stemming from the model, and discuss implications for novel ways to consider both societal stigma reduction and personalized intervention.
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Affiliation(s)
- Michael W Best
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada.
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